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Prevalence and predictors of osteopenia and osteoporosis in patients with type 2 diabetes mellitus: a cross-sectional study from a tertiary care institute in North India

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Abstract

Background

Patients with type 2 diabetes mellitus (T2DM) have an increased risk of hip and vertebral fractures. The increased fracture risk has largely been attributed to poor bone quality and microarchitecture. The contribution of bone quantity, measured as areal bone mineral density (BMD), to the risk of fracture is variable with most studies showing an increase in BMD in T2DM. The present study was undertaken to find out the prevalence of osteoporosis and osteopenia (based on BMD) in a cohort of patients with T2DM and delineate the possible modifiable and non-modifiable risk factors.

Methods

In this cross-sectional observational study, 252 otherwise ostensibly healthy patients with T2DM underwent dual energy X-ray absorptiometry (DEXA) scan. Osteoporosis and osteopenia were defined based on T-scores. The effect of modifiable and non-modifiable risk factors on BMD and osteoporosis were assessed.

Results

The mean age of the cohort was 59.9 years with a M:F ratio 2.9:3.4. The mean BMD at the lumbar spine and hip were 0.892 g/cm2 and 0.715 g/cm2, respectively. Males had significantly higher BMD at both the sites compared to females. The prevalence of osteoporosis and osteopenia was 33% and 40%, respectively. Female gender, increasing age, normal body mass index (BMI), low serum 25-hydroxyvitamin D, and use of pioglitazone were significantly associated with the risk of osteoporosis.

Conclusion

The prevalence of osteoporosis and osteopenia in patients with T2DM is high. Female gender, increasing age, normal BMI, low serum 25-hydroxyvitamin D, and pioglitazone use further increase the risk of osteoporosis.

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Funding

The study was funded by RSSDI (Research Society for the Study of Diabetes in India), Delhi Chapter. Reference number: 2016/43.

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Authors and Affiliations

  1. Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Sarath Aleti, Rimesh Pal & Deba Prasad Dhibar

  2. Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Pinaki Dutta, Vandana Dhiman & Sanjay Kumar Bhadada

  3. Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Mahesh Prakash & Niranjan Khandelwal

Authors
  1. Sarath Aleti
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  2. Rimesh Pal
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  4. Deba Prasad Dhibar
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  7. Vandana Dhiman
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  8. Sanjay Kumar Bhadada
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Correspondence to Sanjay Kumar Bhadada.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institute Ethical Committee, Post Graduate Institute of Medical Education and Research, Chandigarh, India (Reference number NK1739/MD 11259-60).

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Informed consent was obtained from all the participants prior to enrollment.

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Aleti, S., Pal, R., Dutta, P. et al. Prevalence and predictors of osteopenia and osteoporosis in patients with type 2 diabetes mellitus: a cross-sectional study from a tertiary care institute in North India. Int J Diabetes Dev Ctries 40, 262–268 (2020). https://doi.org/10.1007/s13410-019-00786-3

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  • DOI: https://doi.org/10.1007/s13410-019-00786-3

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